HISTORY OF MEDICINE IN AMERICA.
_The Colonial Physicians. Medical Study under Preceptors. Inoculation
against Small-pox. Military Surgery during the Revolutionary War.
Earliest Medical Teaching and Teachers in this Country. The First
Medical Schools. Benjamin Rush. 1745-1813. The First Medical Journals.
Brief List of the Best-Known American Physicians and Surgeons._
The{276} history of medicine in America commences with the early
struggles of the physicians in the American colonies. One Dr. Wootton
came to Virginia in 1607 as Surgeon-General of the London Company. The
following year Dr. Russell was with Captain Smith in his exploration of
Chesapeake Bay. Neither of these men stayed long in the country, since,
in 1609, Captain Smith, after being wounded, was compelled to return to
England for treatment, for lack of medical aid.
When, in 1626. Peter Minuit _purchased the island of Manhattan for the
sum of twenty-four dollars_, there was probably no physician there at
the time. Undoubtedly the first physician, in what is now New York, was
Lamontagne,--a Huguenot, who arrived in 1637, and who seems to have been
a man of great capability for his time. It would appear that men of no
little eminence left the Old World for the New during the early days
of the American colonies, and that the medical services which the early
colonists received were on a par with those received by those whom they
left behind in their old homes. During the seventeenth century a number
of reputable physicians emigrated to this country, among them Dr. John
Clark, of Boston, in 1638, whose son and grandson followed him in his
profession and became prominent in their chosen calling. In 1644 came
Dr. Child, a graduate of Padua, who seems to have been a man of great
learning.
A number of younger Americans also went abroad to{277} study,--Leyden,
Paris, Padua, and the British universities being those most eagerly
sought. In Virginia, so early as 1619, the Colonial Assembly discussed
the erection of a university or college. In 1637 a public college was
established in Cambridge, and in 1638 the Rev. John Harvard left to
it his library and half his fortune, after which it was called Harvard
College. William and Mary College was chartered in Virginia in 1693.
Probably the first lectures in anatomy given in this countrv were those
of Giles Firman, which were given previous to 1647 at Harvard College.
It was in this early day that arose the custom, continued until very
recently, of studying medicine with a preceptor. This was necessary at
that time, and until comparatively recently, because of the scarcity of
institutions of learning and the expense connected with an education.
The form of apprenticeship was often gone through with for a term of
years varying from three to seven, during which time the young student
performed the most menial duties, had very meagre opportunity for
anatomical study, and acquired his knowledge rather by contact with and
absorption from his preceptor than in any other way. In this method
of teaching the personal element was so pronounced that everything, in
fact, depended upon the preceptor, save what natural talent and industry
might accomplish, With such meagre opportunities the means for doing
were equally scant. Nevertheless, emergency made many of these early
American practitioners self-reliant and competent to treat, according to
the knowledge of that day, the various accidents then so common. In
1636 the Assembly of Virginia passed a fee-bill for surgeons and
apothecaries, fees, however, being often paid in tobacco, powder, lead,
wampum, etc. Not a few combined ministry of the body and the soul, and
a number of eminent physicians were also preachers of more or less
renown,--among them John Rogers, John Fisk, and others.
Probably{278} the only medical work published in America during the
seventeenth century was _A Brief Rule to Guide the Common People of
New England how to Treat Them-selves and Others in the Small-pocks or
Measels_. This was printed and sold in 1677, by John Foster, of Boston.
It was printed upon one side of a single sheet in double columns, and
described both of these diseases as due to the blood endeavoring to
recover a new form and state.
The old English distinction between physician and surgeon was for many
years quite generally preserved, but could not persist, because of the
different conditions under which men practiced. During this century,
also, a number of midwives made excellent practitioners,--among them
the wife of Dr. Fuller, one of the _May Flower_ pilgrims. Those colonial
days, however, seem to have been free from the ravages of itinerant
specialists and charlatans, who so abundantly infested Europe at the
time. It is also to the everlasting credit of the American profession
that it took no part in the horrible delusions and scandalous
transactions connected with the Salem witchcraft.
By the beginning of the eighteenth century the population of the United
States was about three hundred thousand whites; by the end of the
century it had increased to a total of about four millions. During this
century a larger proportion of educated medical men came from abroad
and settled in various parts of the country, while the Colonial and the
Revolutionary Wars offered ample opportunity for the development
and study of military medicine and surgery. Commerce between the two
continents increased; communication became more free, and the people of
the Old World and the New were constantly brought into closer relation.
The most lively medical controversy of the century was, probably, that
excited over the introduction of vaccination against small-pox. In
previous sketches I have had to intimate that the greatest enemy of
the medical profession in time past has been the clergy. In this{279}
particular instance, however, it was to the Rev. Cotton Mather, of
Boston, that the profession is largely indebted for the favor with
which the new method was received in this country. In 1721 he called the
attention of various American physicians to the method, then in vogue in
Turkey, of inoculation with virus from the active disease. Dr. Boylston,
of Brookline, Mass., who settled in Boston, corresponded with members
of the British Royal Society and finally determined to put the method
to actual proof. In 1721 he inoculated his own son with the virus of
natural small-pox, and within the next year had inoculated two hundred
and forty-seven persons, of whom about two per cent, died of the
disease; while, of nearly six thousand persons attacked by the disease
in the natural way, more than fourteen per cent. died. In spite of this,
the man and the method were violently attacked by the people and the
profession, and found their warmest defenders among the ranks of the
clergy. Benjamin Franklin, then only sixteen years of age, joined with
the rabble in opposing the inoculation method. Boylston was threatened
with hanging, and had even to hide himself for a time, he died in 1766.
After the great discovery of Edward Jenner societies were formed for the
promotion of vaccination all over the world. The earliest vaccination
in the United States was performed by Dr. Waterhouse (born 1754, died
1846), who operated upon four of his own children in 1800.
[Illustration: 0300]
It was during the eighteenth century that a number of our best-known
educational institutions were founded in the different colonies,--among
them, Yale College, in 1701; Princeton (College of New Jersey), in 1746;
University of Pennsylvania, in 1749; Columbia (King's College), in
1754; and others, only a little less known. In most of these latter were
established medical departments, but the method of apprenticing students
to physicians was still in general observance, no preliminary education
whatever, as a rule, being demanded. In 1766, however{280}, the
New Jersey Medical Society ordained that no student be taken as
an apprentice by any member of the society unless he had competent
knowledge of Latin and some initiation in the Greek. About the middle of
the century Drs. Bard and Middleton, in New York, and Dr. Cadwallader,
in Philadelphia, began giving lectures in anatomy, while at Newport,
Rhode Island, Dr. William Hunter, between 1754 and 1756,--a near
relative of the famous Hunters of London, and a pupil of the elder
Monro,--gave a course of lectures on human and comparative anatomy. Dr.
William Shippen. Jr. (1736-1808),--a student of John Hunter's,--returned
in 1762 to America, and gave his first course of lectures on anatomy and
midwifery during the years immediately following. His lectures led to
the formation of a Medical Department of the College of Philadelphia,
in 1765, in which lectures were continued regularly until the winter of
1775, when the{281} War of the Revolution interfered. In July of 1776
Shippen was made Chief-Physician of the Continental Army, and in
the following year was elected by the Provincial Congress
Director-in-General of army hospitals. During the latter years of the
war he returned to Philadelphia each winter, and delivered a course
of lectures, shortened by the necessities of the case. Thus he was the
first public teacher of midwifery in this country. He was ably seconded
in his work by Dr. John Morgan (1735-1789),--also a pupil of Hunter and
Monro, who received a prominent army appointment in 1775, but who, two
years later, was unfortunately dismissed on charges{282} subsequently
proved false. Shippen and Morgan were for some time the only professors
in the Medical Department of the College of Philadelphia. In 1768
Kuhn--a pupil of Linnæus--was made Professor of Materia Medica and
Botany; and Benjamin Bush, a year later, was given the Chair of
Chemistry. The commencement of this institution occurred in 1768, when
the degree of M.B. was given to seventeen graduates. In 1779 political
reasons led to the abolition of the College of Philadelphia, the
University of Pennsylvania taking its place. Ten years later the former
institution was restored, and in 1791 the two institutions were united.
The present Medical Department of the University of Pennsylvania is,
therefore, the legitimate continuation of the first medical school in
America.
[Illustration: 0301]
The Medical Department of King's College, New York, now Columbia
College, was organized in 1767, by Clossey, an Irishman; Middleton,
a Scotchman; James Smith, a graduate of Leyden; Tenant, an alumnus of
Princeton College; and Bard, who was by far the most eminent of the
group, a Philadelphian by birth, who had studied under the best masters
in England.
The Medical Department of Harvard University was organized in 1783. Most
prominent in connection with it was Dr. John Warren, the first teacher
of anatomy and surgery, and the founder of a family of eminent medical
men, whose descendant, Dr. J. Collins Warren, is to-day an occupant
of the chair of surgery in the same school. The Medical Department of
Dartmouth College was organized in 1798 by Dr. Nathan Smith,--a man of
great energy and unusual versatility.
While these medical colleges were developing their strength the medical
profession were not idle, and institutions and libraries sprang up in
various places. The Pennsylvania Hospital, for instance, founded in
1762, is to be credited with the oldest medical library in this country,
many{283} of its volumes having been selected especially for it by
Louis, of Paris, and the famous Lettsom, of London. It now contains
nearly fifteen thousand volumes. The library of the New York Hospital,
not quite so large, was founded in 1776; that of the College of
Physicians, in Philadelphia, in 1788. The profession of New Jersey
organized the State Medical Society in 1765. In 1781 was founded the
Massachusetts Medical Society. In 1787 arose the College of Physicians
of Philadelphia.
In 1789 the profession of Maryland organized the so-called Medical
and Chirurgical Faculty of Maryland, constituting thereby the same
organization as the societies of other States. Before the close of the
century, Delaware, New Hampshire, and South Carolina had also
organized societies. In the larger cities extensive hospitals were also
founded,--the Pennsylvania Hospital, in Philadelphia, in 1751, inside
of which the first clinical instruction in this country was given by Dr.
Thomas Bond. The New York Hospital began in 1769, simultaneously with
the organization of the Medical Department of King's College. The first
insane-asylum in America was built at Williamsburgh, Va., in 1773,
although the charter of the Pennsylvania Hospital, dated 1751, provided
for the care of lunatics, though not at that time in a separate
institution.
[Illustration: 0304]
The most conspicuous medical character of the century in American
history was undoubtedly Benjamin Rush (1745-1813). He was one of
Shippen's earliest students in anatomy, studied widely abroad, was
a member of the Continental Congress, and one of the signers of the
Declaration of Independence. After him is named Rush Medical College of
Chicago. He was an extensive writer on a variety of subjects, not only
professional, but political, philosophical, etc. He recognized but two
kinds of remedies,--stimulants and depressants,--and held it to be
the principal duty of the physician to decide as to which were most
advisable in a given case. He called calomel the "Samson"{284} of the
materia medica, and his opponents contended that he was right, since it
had undoubtedly slain its thousands. As an accurate observer of disease,
he was correct and exact, and his descriptions are to-day both classic
and reliable.
The study of practical anatomy lias always been carried on in this
country under great disadvantages. At first only the bodies of executed
criminals were sparingly furnished.
In 1788, in New York, occurred the celebrated "doctor's mob," which
attested the vehemence of public objection to dissection, and which for
two days defied the control of all the authorities. Secret dissections
had been practiced in Harvard College so early as 1771, but the practice
was against the law even for sixty years later in Massachusetts.
Physiology, as such, was not taught in any medical school in this
country during the century, and experimental{285} physiology was
practically unknown. Surgery was eagerly studied, especially during war
times, and Dr. John Jones (1729-1791), of the King's College School,
was, perhaps, the most eminent of the surgeons of his day. Others who
vied with him were William Shippen, Jr., the first teacher of surgery in
the College of Philadelphia; John Warren, of Boston; Richard Bayley, of
Connecticut; Baynham, of Virginia; and McKnight, of New York.
The position of midwifery during the earlier years of the country may
be, perhaps, understood by the following extract from the _New York
Weekly Post-Boy_, of July, 1745:--
"Last night died, in the prime of life, to the almost universal regret
and sorrow of this city, Mr. John du Puy, M.D., man-midwife," etc.
The first practitioner of obstetrics in New England was Dr. Lloyd
(1723-1810), a pupil of Hunter and Smelley; while Dr. Shippen, in
Philadelphia, endeavored to organize a school for the instruction of
midwives, in which, however, he met with insuperable difficulties.
The first attempt to regulate practice in colonial times was an act
passed by the General Assembly of 1760, providing for at least a form of
examination in physic and surgery, registration, etc. The first medical
journal to appear in the United States appeared about 1790. It was
entitled _A Journal of the Practice of Medicine and Surgery and Pharmacy
in the Military Hospitals of France_, consisting merely of translations
from the French journals of military medicine. The first real American
medical journal was the _Medical Repository_, begun in 1797 and
discontinued in 1824.
The present century, now drawing to its close, saw in its earlier half
the rise of a large number of American physicians and surgeons who have
made their names illustrious for all time by their teachings, their
writings, and their invention and originality. While it is, of course,
invidious to{286} select names, the following certainly deserve
honorable mention in this list, without the slightest disrespect or
intentional slight to many others whose names must be omitted for want
of space.
John R. Cox (1773-1864), an early student of Benjamin Rush, filled the
chair of Materia Medica and Pharmacy in the University of Pennsylvania,
and published the _American Dispensatory_ in 1806. Caspar Wistar
(1761-1818) was the author of a _System of Anatomy_,--held in great
favor in his day as a text-book. Nathaniel Chapman (1780-1853) was
Professor of Theory and Practice in the University of Pennsylvania until
1850. John Eberle held the similar chair of the Jefferson School from
1825-1831. The former wrote on _Materia Medica and Therapeutics_, the
latter on the _Practice of Medicine_, both works being exceedingly
popular. John W. Francis (1789-1861) taught{287} obstetrics in the
College of Physicians and Surgeons from 1826-1830. Franklin Bache
(1792-1864) was one of the authors of the _Dispensatory of the United
States of America_, published in conjunction with George B. Wood, who
was Professor of Materia Medica in the University of Pennsylvania, and
who wrote also extensively on his chosen subject in monographs and large
works.
[Illustration: 0306]
Robley Dunglison (1789-1869) taught for a number of years in the
University of Virginia, but removed later to the Jefferson School in
Philadelphia. He was a man of great industry and versatility, and
wrote on a variety of subjects, his best-known work being his _Medical
Dictionary._
[Illustration: 0307]
W. E. Horner (1793-1853) taught anatomy and histology in the University
of Pennsylvania, and will long be remembered for his researches in these
branches. John W. Draper (1811-1882) made himself eminent as well by
his researches in photography{288} and in general science, as by the
publication of his treatise on _Human Physiology_, which first appeared
in 1853. Better known as physiologist was John C. Dalton (18251889),
whose text-book is to-day studied in many colleges and who first
introduced the method of vivisectional classroom demonstrations in our
own school here in Buffalo.
Alonzo Clark (1807-1887) was one of the most eminent teachers of
medicine that this country has produced. Austin Flint (1812-1886)
was also a famous teacher of medicine in New York, who made his first
reputation in the then small school in Buffalo.
[Illustration: 0308]
His text-book on _Practice_ is the most popular American work on the
subject that has ever appeared, and is still in general use. William P.
Dewees (1768-1841){289} was the author of a treatise upon _Diseases of
Children_, which reached a tenth edition and which rivaled the similar
treatise of John Forsyth Meigs. The best-known teacher of dermatology
and venereal diseases was Freeman J. Bumstead (1826-1879), author of the
most popular work upon the latter subject that has been issued from the
medical press. He wras professor of these diseases at the College of
Physicians in New York. His text-book vied with that produced by William
H. Van Buren (1819-1883), who, in connection with Dr. Keyes (still
living), wrote a treatise upon the _Surgical Diseases of the
Genito-Urinary Organs_, including syphilis, which has been, since its
appearance, exceedingly popular with the medical profession.
Among the best-known neurologists and alienists of the century since
Benjamin Rush wrote his _Inquiries and Observations upon Diseases of the
Mind_ (1812){290} was Dr. Isaac Ray, who, in 1838. published a work upon
the medical jurisprudence of insanity.
[Illustration: 0309]
Dr. Brigham ( 1798-1849) was superintendent of the Utica Insane-asylum
for some years before his death; and Dr. Kirkbride, who died in 1883,
had been superintendent of the Philadelphia Asylum for over forty years.
Dr. John P. Gray followed Brigham as superintendent of the Utica Asylum,
where he remained for thirty-two years, and founded the _Journal of
Insanity_.
The first independent writer upon diseases of the eye was Dr. Frick
(1793-1870), of Maryland. As illustrating how little our present
specialties were then separated, it is worth while to remark that Dr.
Edward Delafield (1794-1875), who, in 1826. was Professor of Obstetrics
and Diseases of Women and Children in the College of Physicians and
Surgeons, New York, delivered at the same time a special course of
lectures upon diseases of the eye. The first man in the United States
to make these diseases his exclusive specialty was Dr. Williams
(1822-1888), of Cincinnati.
It would be very wrong, in this connection, to omit the mention of the
name of Oliver Wendell Holmes, the genial "Autocrat of the Breakfast
Table," but recently dead at a ripe old age, who used to say that he was
"seventy years young." who was for a long time Professor of Anatomy at
Harvard Medical College, but who was much more widely known and
endeared to the English-speaking public by his beautiful poems and most
attractive prose writings.--who, as author of the _Chambered Nautilus_,
for instance, will be remembered so long as the English language has
a literature and is read, he rendered a great service to the medical
profession by first calling attention to the contagiousness of puerperal
fever. Of his prose writings, his medical essays--entitled _Currents and
Counter-currents_--make perhaps the most delightful reading.
Not{291} a few Americans deserve special mention as surgeons and
surgical teachers of eminence during the past hundred years. Without
being invidious, there must, nevertheless, be mentioned John Collins
Warren (1778-1856), first Professor of Anatomy and Surgery in the
Harvard School, under whose auspices ether was first administered for
the purpose of surgical anæsthesia, and who was the founder, in 1828, of
the _Boston Medical and Surgical Journal_. He wrote an extensive
treatise upon tumors, and, it is stated, first successfully tapped the
pericardium.
[Illustration: 0311]
Philip S. Physick (1768-1837), a pupil of Hunter, has been spoken of as
the "father of American surgery," which he taught in the University
of Pennsylvania. He was a tremendous worker, but wrote very little. He
employed animal ligatures made of buckskin. John Syng Dorsey (1783-1818)
was a nephew of Physick; taught anatomy in{292} the University of
Pennsylvania; wrote a treatise on surgery, which was the second surgical
text-book published in this country, and was the first in the United
States to tie the external iliac artery. He died at the age of
thirty-five, at a time when he was giving promise of exceeding eminence.
Nathan Smith taught in Dartmouth, Yale, and Bowdoin Colleges, and 'was
considered the best man of his day in New England.
[Illustration: 0312]
To him is justly due the great honor of having performed the first
rational and deliberate ovariotomy, which he did in 1809, his patient
living for thirty-two years. The operation was performed without an
anæsthetic, and considering the circumstances under which it was carried
out has shed a lustre upon his name and brain which nothing can ever
dim. By this performance he became practically the father of modern
abdominal surgery, and to him Americans and{293} Europeans alike are
delighted to render all the honor that is his due.
Perhaps the most eminent surgeon of the country was Valentine Mott
(1785-1865), a pupil of Cooper and Bell, who taught in the College of
Physicians and Surgeons, New York, until 1840, and in the University
Medical School until 1860. He was a man of exceeding boldness and
brilliancy, whose operations were performed at a time when anaesthesia
was unknown, or was in its infancy, and who probably did more work in
the surgery of the vascular system than any other surgeon who has ever
lived. He was the first to tie the arteria innominata,--in 1818. As
Gross wrote of him, he had a record of one hundred and thirty-eight
ligations of various large arteries,--a record probably never equaled.
He was also the first to do a successful extirpation of the clavicle for
tumor,--an operation which at that time was considered very formidable.
Though not a great writer himself, he is best known among students
as the translator and editor of Velpeau's large work upon operative
surgery.
Dr. George McClellan (1796-1847) was the founder of the Jefferson
Medical School, and its first Professor of Surgery. He was followed
later by Dr. Thomas D. Mutter, who left his surgical museum to the
College of Physicians of Philadelphia and endowed a lectureship there.
J. K. Rodger, of New York; John Rhea Barton, of Philadelphia; William
Gibson, of Philadelphia; Gurdon Buck, of New York; Willard Parker, of
New York; Frank H. Hamilton, of New York, who made his reputation while
teaching in our Buffalo school, author of a most popular and valuable
treatise upon fractures and dislocations; and Henry B. Sands, of New
York, were men of greatest prominence during the middle and latter
portion of the present century, each of whom has contributed in his
way either to the science or to the literature of surgery. The most
prominent figure in American surgery of the past forty{294} years was
Samuel D. Gross, of Philadelphia, professor in the Jefferson School,
to which he moved from Kentucky, where he laid the foundation for his
attainments and reputation.
[Illustration: 0314]
He was an early writer upon surgical pathology and anatomy, but is best
known for his elaborate _System of Surgery_, in two large volumes, which
has survived several editions and is still most highly esteemed. Among
others who ought to be mentioned are Nathan R. Smith, of Baltimore,
the inventor of the anterior splint; Paul F. Eve, of Nashville; John
T. Hodgen, of St. Louis; Daniel{295} Brainard, of Chicago, and his
successor, Moses Gunn; Alden March, of Albany; Henry J. Bigelow, of
Boston, who performed the first excision of the hip in this country, in
1852, and who invented the method of crushing and removing stone from
the bladder at a single operation, known as litholapaxy; and D. Hayes
Agnew, of Philadelphia, who finished, before his death, a large and
elaborate treatise on surgery, in three thick volumes.
Of obstetricians and gynaecologists America has had no lack, and, in
fact, the United States may almost be said to be the first home of
gynaecology. Dr. Bard was the first Professor of Midwifery in King's
College, now Columbia, New York, and the author of the first work upon
the subject published in this country. In Philadelphia, Dr. Thomas C.
James (1756-1835) was the first distinct teacher of obstetrics, his
chair falling later to Dewees, already mentioned, who wrote extensively
on midwifery and the diseases of children and of women. The same chair
in the University of Pennsylvania was filled later by Hugh L. Hodge
(1796-1873), a man of great originality and independence, who published
a most elaborate and beautiful work upon his branch, which will always
remain a classic. Charles D. Meigs, professor in the Jefferson School,
Philadelphia, was the first to direct attention to thrombosis as a
cause of sudden death in childbirth. He wrote both on gynaecology
and midwifery. Bedford, of Baltimore, was another popular teacher
and writer, with whom deserves to be mentioned William H. By ford, of
Chicago, who wrote on both obstetrics and gynaecology.
Gynaecology owes much to the efforts of American schools and
practitioners. The first successful attempt of McDowell's, already
alluded to, was imitated by Nathan Smith in 1821; and during the next
forty years thirty-six ovariotomies had been performed by eighteen
different surgeons,{296} with a record of twenty-one recoveries.
[Illustration: 0316]
Probably the most prominent passed figure in American gynaecology is
J. Marion Sims (1813-1883), born in the South, where he invented his
well-known speculum in 1852, whose introduction marked an epoch in
the treatment of the pelvic diseases of women. It was also in South
Carolina, among poor negro patients, that he perfected his method of
plastic operations in the vagina for the relief of vesical fistulæ,
which he later demonstrated in Paris to the astonishment of incredulous
Parisian surgeons, who had almost uniformly failed in their attempts,
and which he later successfully and brilliantly performed in all the
capitals of Europe, where, as in this country, he enjoyed the greatest
reputation. He was the founder of the great Woman's Hospital in New
York, in 1855, an institution from which has proceeded more good
gynæcological teaching than from any similar institution in the world
Other ovariotomists{297} and gynaecologists of great merit were John
L. Atlee, and his brother Washington Atlee, of Pennsylvania; Dunlap, of
Springfield, Ohio; Peaslee, of New York, who wrote the first American
treatise on ovarian tumors; Kimball, of Lowell, Massachusetts; and D. H.
Agnew, of Philadelphia, who is, perhaps, yet better known as a general
surgeon because of his _magnum opus_,--his _Treatise on Surgery_, in
three large volumes, already mentioned.
[Illustration: 0317]
After{298} this brief _résumé_ of the names and achievements of the
best-known American physicians and surgeons no longer living, it remains
only to say a few words with regard to the general character of their
work and attainments. It certainly was the case, during the earlier
and middle portions of this century, that men had much to gain, beside
addition to their vernacular, by study in foreign countries. Edinburgh
and London were, at first, the centres to which men flocked; during the
middle of the century they gathered in Paris, attracted by such men as
Broussais, Velpeau, and others; after which the tide of travel turned
toward Germany, where the government does more for the education of
medical men and the furnishing of distinct opportunities than is done in
any other part of the world. But, thanks to the influence of the foreign
schools and the receptivity and natural quickness of the American mind,
we have reached a point in this country when it is no longer necessary
for American students to visit the foreign centres for this purpose,
advantageous as these may be in many respects. The only feature in which
we are yet lacking is the matter of government aid and the government
control of medical institutions, by which better opportunities may be
afforded for pathological study. Aside from this, and the centralization
of cases which government control permits, it may be said that the
Americans are in all respects as good practitioners as--and in most
respects better than--their foreign colleagues. They evince more of
humanity, more of real interest and care in their patients, and more
consideration for their comfort and welfare; while, in all that pertains
to fertility of invention, to originality of performance, and accuracy
of work, they, as a rule, excel. Divested of glamour, American surgery,
both general and special, is ahead of most of that which one can see
abroad, and the therapeutics of the American profession certainly
surpass those of any other nationality. No one need feel, then, that it
is necessary to go abroad for any{299} purpose, unless it may be that
polish and wide range of general information that necessarily come from
travel and observation among other nations and peoples. In practical
medicine, then, as in practical living, America leads the world.